Prospects in the field of medical rehabilitation
Ukrainian society today is just learning to understand what inclusiveness and tolerance for people with special needs is. And these terms themselves have recently entered the vocabulary and use of our citizens. We inherited the habit of "burying" people with disabilities from the Soviet government. All those who did not meet the criteria of the norm were "closed" in institutions somewhere out of sight. The worst and most painful thing is that there were children in this system who had to spend their whole lives in isolation from society, and therefore never had the chance to become full members, but at least somehow to integrate into it. Armed with the thesis that the old principles need to be changed, and that only an inclusive society can be called civilized, the Ministry of Health of Ukraine aims to introduce a new approach to medical rehabilitation in general in the near future.
According to the WHO, more than 1 billion people in the world have some form of disability. As of the beginning of 2019, there were 2.6 million people with disabilities in Ukraine, of which 161,000 were children. Most of them need quality and evidence-based rehabilitation. The Ministry knows that today the system of rehabilitation medicine is rather fragmentary, it practically does not apply a multidisciplinary approach. However, timely care prevents the emergence of human limitations that lead to disability, promotes the maximum possible recovery of body functions and adaptation to an active full life. Therefore, the Ministry of Health emphasizes that "treatment" with baths with clay, paraffin or electricity, ie methods that do not have proven effectiveness, should remain forever in the past.
An action plan for the implementation of the IFF (International Classification of Functioning , Restrictions on Life and Health and the International Classification of Functioning, Restriction of Life and Health of Children and Adolescents ) has already been approved in Ukraine. The IFF is a classifier used in all developed countries by doctors, educators, rehabilitation specialists and psychologists, but which is not is an evaluation tool. Functioning and limitation of life through the International Classification of Functioning is considered as an interaction between the environment and human health, and therefore the classifier creates a more integrated understanding of health, provides better planned treatment, rehabilitation and services for people with chronic diseases or disabilities .
Also, the Nomenclature of Medical Specialties added "Physical and Rehabilitation Medicine" and introduced the qualifications of most rehabilitation specialists: physician of physical and rehabilitation medicine, physical therapist (Healthcare professional who identifies and maximizes the quality of life and motor potential of a person in the process of development, prevention, treatment / intervention, habilitation and rehabilitation in the field of physical, psychological, emotional and social well-being ( occupational therapist), occupational therapist health care, which not only restores lost or limited functions of movement and coordination, but also re-teaches a person to live in new conditions, helping him to achieve maximum independence and independence in life, work, have fun, learn new hobbies and communicate) , assistant physical therapist, assistant occupational therapist.
In the future there is also a reform of medical and social expertise (draft concept already developed) that changes the approach to disability - the patient must receive services medical rehabilitation services from the moment of health problems to the maximum possible level of recovery, and not only after the establishment of disability status.
It is also known that in 2020 rehabilitation will be included in the Medical Guarantee Program. UAH 449 million has been allocated for it in the state budget.
Medical rehabilitation was first discussed in the world after the First World War. In medicine, the term "rehabilitation" for people with disabilities began to be used in 1918, when the Red Cross Institute for the Disabled was organized in New York, - says Irina Berlinets, scientist of Lviv Medical Academy. A. Krupinsky. - Approaches and ideology of rehabilitation have evolved. Yes, in the 40’s . Most attention was paid to monitoring the sick and injured, since the 1950s the understanding of the integration of people with disabilities into society has deepened, and in the 1970s and 1980s this focus was on adapting the environment to people with disabilities and developing vocational adaptation. In the EU, medical rehabilitation is a separate, independent medical specialty that focuses on promoting physical and cognitive functioning, activities, participation (including quality of life) and modification of personal and environmental factors. XX
Medical rehabilitation specialists are based on a holistic approach to people with acute and chronic conditions, such as musculoskeletal and neurological problems, after amputations, pelvic dysfunction, cardio-respiratory failure and disorders due to chronic pain or cancer. Rehabilitation doctors work in various institutions - from acute units to public institutions. They use special diagnostic tools and for rehabilitation purposes use tools that include pharmacological, physical, technical, educational and professional interventions. In the West (Europe, USA) the patient does not lie in the ward for 7-14 days after the operation and does not occupy the bed, does not spend money on his food, as is the case in Ukraine, and is sent to the rehabilitation department, In addition, it has been scientifically proven that if a person does not rehabilitate for 3 weeks, but simply lies down, he loses about 30-40% of his functionality and the rehabilitator at a later date is harder to work. In Europe and the United States, each hospital has large rehabilitation centers staffed by highly qualified rehabilitation physicians. The patient is sent there for 3-4 days after the operation. This greatly simplifies treatment, saves the patient’s time and leads to faster recovery. In Ukraine, a patient after a long stay in hospital must seek a rehabilitation specialist. Latvia, for example, began reforming rehabilitation medicine 20 years ago. We started with the education of future specialists, for which the state allocated significant amounts of funding.
Currently, there are two systems in Latvia - a spa and a new multidisciplinary one. Multidisciplinary teams have been established in all sanatoriums, which effectively provide medical rehabilitation services, however, doctors of the old system still remain with them. The state allocates funds for the introduction of new methods of medical rehabilitation, but if the patient wants to use the old methods, he pays for these services himself, "said Berlinets.
Thus, Ukraine has significant prospects in the field of medical rehabilitation. The main thing is not just to talk about it at all levels of government, but to reinforce words with actions and bring the started actions to an effective end.
Author Kateryna Stebelska
Read also: Tea, food and accommodation: where and when to open heating stations for the homeless
According to the WHO, more than 1 billion people in the world have some form of disability. As of the beginning of 2019, there were 2.6 million people with disabilities in Ukraine, of which 161,000 were children. Most of them need quality and evidence-based rehabilitation. The Ministry knows that today the system of rehabilitation medicine is rather fragmentary, it practically does not apply a multidisciplinary approach. However, timely care prevents the emergence of human limitations that lead to disability, promotes the maximum possible recovery of body functions and adaptation to an active full life. Therefore, the Ministry of Health emphasizes that "treatment" with baths with clay, paraffin or electricity, ie methods that do not have proven effectiveness, should remain forever in the past.
An action plan for the implementation of the IFF (International Classification of Functioning , Restrictions on Life and Health and the International Classification of Functioning, Restriction of Life and Health of Children and Adolescents ) has already been approved in Ukraine. The IFF is a classifier used in all developed countries by doctors, educators, rehabilitation specialists and psychologists, but which is not is an evaluation tool. Functioning and limitation of life through the International Classification of Functioning is considered as an interaction between the environment and human health, and therefore the classifier creates a more integrated understanding of health, provides better planned treatment, rehabilitation and services for people with chronic diseases or disabilities . Also, the Nomenclature of Medical Specialties added "Physical and Rehabilitation Medicine" and introduced the qualifications of most rehabilitation specialists: physician of physical and rehabilitation medicine, physical therapist (Healthcare professional who identifies and maximizes the quality of life and motor potential of a person in the process of development, prevention, treatment / intervention, habilitation and rehabilitation in the field of physical, psychological, emotional and social well-being ( occupational therapist), occupational therapist health care, which not only restores lost or limited functions of movement and coordination, but also re-teaches a person to live in new conditions, helping him to achieve maximum independence and independence in life, work, have fun, learn new hobbies and communicate) , assistant physical therapist, assistant occupational therapist.
In the future there is also a reform of medical and social expertise (draft concept already developed) that changes the approach to disability - the patient must receive services medical rehabilitation services from the moment of health problems to the maximum possible level of recovery, and not only after the establishment of disability status. It is also known that in 2020 rehabilitation will be included in the Medical Guarantee Program. UAH 449 million has been allocated for it in the state budget.
Medical rehabilitation was first discussed in the world after the First World War. In medicine, the term "rehabilitation" for people with disabilities began to be used in 1918, when the Red Cross Institute for the Disabled was organized in New York, - says Irina Berlinets, scientist of Lviv Medical Academy. A. Krupinsky. - Approaches and ideology of rehabilitation have evolved. Yes, in the 40’s . Most attention was paid to monitoring the sick and injured, since the 1950s the understanding of the integration of people with disabilities into society has deepened, and in the 1970s and 1980s this focus was on adapting the environment to people with disabilities and developing vocational adaptation. In the EU, medical rehabilitation is a separate, independent medical specialty that focuses on promoting physical and cognitive functioning, activities, participation (including quality of life) and modification of personal and environmental factors. XX
Medical rehabilitation specialists are based on a holistic approach to people with acute and chronic conditions, such as musculoskeletal and neurological problems, after amputations, pelvic dysfunction, cardio-respiratory failure and disorders due to chronic pain or cancer. Rehabilitation doctors work in various institutions - from acute units to public institutions. They use special diagnostic tools and for rehabilitation purposes use tools that include pharmacological, physical, technical, educational and professional interventions. In the West (Europe, USA) the patient does not lie in the ward for 7-14 days after the operation and does not occupy the bed, does not spend money on his food, as is the case in Ukraine, and is sent to the rehabilitation department, In addition, it has been scientifically proven that if a person does not rehabilitate for 3 weeks, but simply lies down, he loses about 30-40% of his functionality and the rehabilitator at a later date is harder to work. In Europe and the United States, each hospital has large rehabilitation centers staffed by highly qualified rehabilitation physicians. The patient is sent there for 3-4 days after the operation. This greatly simplifies treatment, saves the patient’s time and leads to faster recovery. In Ukraine, a patient after a long stay in hospital must seek a rehabilitation specialist. Latvia, for example, began reforming rehabilitation medicine 20 years ago. We started with the education of future specialists, for which the state allocated significant amounts of funding.
Currently, there are two systems in Latvia - a spa and a new multidisciplinary one. Multidisciplinary teams have been established in all sanatoriums, which effectively provide medical rehabilitation services, however, doctors of the old system still remain with them. The state allocates funds for the introduction of new methods of medical rehabilitation, but if the patient wants to use the old methods, he pays for these services himself, "said Berlinets.
Thus, Ukraine has significant prospects in the field of medical rehabilitation. The main thing is not just to talk about it at all levels of government, but to reinforce words with actions and bring the started actions to an effective end.
Author Kateryna Stebelska
Read also: Tea, food and accommodation: where and when to open heating stations for the homeless